Effect of transcatheter arterial embolization with a mixture of n-butyl cyanoacrylate, lipiodol, and ethanol on the vascular wall: macroscopic and microscopic studies

Purpose To compare the pathologic effect of a mixture of n -butyl cyanoacrylate (NBCA), lipiodol, and ethanol (NLE) with a mixture of NBCA and lipiodol (NL) on the embolized vascular wall. Materials and methods Embolization was performed using four swine with NBCA and lipiodol in a volume ratio of 1:1 (NL11group) in the common hepatic artery ( n = 1) and the internal iliac artery ( n = 2); and with NBCA, lipiodol, and ethanol in a volume ratio of 1:1:2 (NLE112 group) in the common hepatic artery ( n = 3) and the internal iliac artery ( n = 6). Results NL11 casts had an intricate appearance in reticular configuration with red thrombus, while NLE112 casts presented in a single round configuration with surrounding ring-like red thrombus. Desquamation of endothelial cells and infiltration of neutrophils into the adventitial layer were found in all embolized vessels in both groups. Infiltration of neutrophils into the intermediate layer was found in the NL11 group but not in the NLE112 group. Conclusion The damage to the vascular wall caused by NLE112 was milder than that by NL11, implying the adverse effects of NLE112 are within tolerable limits.